Provider Demographics
NPI:1376677310
Name:DAN RANGER MEDICAL EQUIPMENT AND SUPPLIES, INC.
Entity Type:Organization
Organization Name:DAN RANGER MEDICAL EQUIPMENT AND SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BABATUNDE
Authorized Official - Middle Name:OLUSEYI
Authorized Official - Last Name:SANWO
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:213-291-1482
Mailing Address - Street 1:6109 S WESTERN AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-1458
Mailing Address - Country:US
Mailing Address - Phone:213-291-1482
Mailing Address - Fax:213-291-0565
Practice Address - Street 1:6109 S WESTERN AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-1458
Practice Address - Country:US
Practice Address - Phone:213-291-1482
Practice Address - Fax:213-291-0565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44038171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5609730002Medicare NSC